Business & Real Estate

Agreement with Covered California opens door for VSP vision care

Covered California said Wednesday that it will offer consumers access to vision plans under a new agreement with VSP Vision Care, seemingly ending a longtime dispute between the state-run health care marketplace and vision insurer VSP Global.

Officials said visitors to CoveredCA.com can now access VSP via a link, which will take consumers to VSP’s website – vspdirect.com/4ca. From the VSP site, consumers can shop for vision benefits and see what coverage options are available.

As part of the agreement, officials said VSP will conduct annual consumer surveys and provide quarterly enrollment reports to Covered California based on those who have accessed VSP through Covered California’s website.

“This decision will help close the gap in access to eye care for Californians who get their health insurance through the exchange,” VSP Global President and CEO Jim McGrann said in a statement.

Covered California stressed that adult vision care is not an essential health benefit under the Affordable Care Act, and coverage is handled directly through VSP. Vision services for children are an essential health benefit and are included in all health plans purchased through Covered California. Enrollment with VSP into vision plans is available year-round, and there are no open-enrollment dates.

The announcement comes after years of frustration on VSP’s part as it claimed it was being unfairly locked out of the extensive Covered California electronic marketplace. Rancho Cordova-based VSP Global is the parent of VSP Vision Care.

In 2012, when the governing board of Covered California was finalizing its rules to operate under the federal Affordable Care Act, it decided not to let “stand-alone” companies like VSP, which provided only vision care insurance, sell coverage to individuals. VSP was stunned. Then-president and CEO Rob Lynch subsequently said he was putting on hold a significant expansion of the company’s operations in the Sacramento area, prompting elected officials and area business leaders to ask the state agency to reconsider.

Eventually, Covered California’s board reversed course and voted to let VSP and other stand-alone insurers into the market for individuals. And VSP gave its area expansion the green light.

However, due to a wrinkle in federal law, Covered California later realized that stand-alone vision plans couldn’t be sold through an exchange, according to a legislative analysis of AB 1877, by Assemblyman Ken Cooley, D-Rancho Cordova.

Cooley’s bill would have established a new entity, called the California Vision Care Access Council, to create a separate website for vision coverage. The bill was seen as a way to work around federal regulations and give stand-alone insurers a way to sell coverage. Insurers would have put up the money to run the operation.

But things blew up when Gov. Jerry Brown vetoed the bill in September 2014, saying it would create an unnecessary “new state bureaucracy.”

On Wednesday, all the rancor seemed like a distant memory.

“Vision coverage is important for our members’ overall health, and Covered California has made it easier than ever for them to find quality vision care options through VSP,” Covered California Executive Director Peter V. Lee said in a statement accompanying Wednesday’s announced agreement.

Mark Glover: 916-321-1184, @markhglover

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